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Florin Lazăr PhD, Lecturer Doru Buzducea PhD, Assoc . prof .

The challenges of care and support for a generation of nosocomially infected young adults from Romania living with HIV . Florin Lazăr PhD, Lecturer Doru Buzducea PhD, Assoc . prof . University of Bucharest, Faculty of Sociology and Social Work . Introduction (1).

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Florin Lazăr PhD, Lecturer Doru Buzducea PhD, Assoc . prof .

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  1. The challenges of care and support for a generation of nosocomially infected young adults from Romania living with HIV Florin LazărPhD, Lecturer DoruBuzducea PhD, Assoc. prof. University of Bucharest, Faculty of Sociology and Social Work

  2. Introduction (1) • 10,000 children nosocomially(use of unsafe syringes and blood products) infected (1988-1992, 50% of AIDS pediatric in Europe until 2000) - about 3,000 died and other 7,000 have survived for over 22 years with HIV. • 1996-1998 ART • Average survival ratio of people with AIDS increased from 31 months in 1996 to 82 months in 2010

  3. Introduction (2) • a peak increase of those availing of social entitlements (see table), • 2004-2010 Global Fund projects implemented • a higher proportion receiving cash benefits (a food allowance) which ensures greater confidentiality. *requires social inquiry/registration with local authorities **paid to bank account, based on medical certificate

  4. Introduction (3) • Romania is now a low prevalence country for HIV (0.1%) • ARV coverage – 81-83% BUT • In 2010 – unintended treatment interruptions • Budgetary cuts & delays in ARV procurement • NGOs protests

  5. Objectives • To assess the access to ARV therapy for PLHIV in Romania • To describe the scope of treatment interruptions in 2010

  6. Methods • A nationally representative clinic-based research among PLHIV (15+ years, N=618, ±4% ) • March –June 2011 • Sample was weighted according to subjects' surveillance center registration (9 centers) • Data collection – by professionals from CBOs & organisations of PLHIV (UNOPA, Sens Pozitiv, ARAS &Alături de Voi) • Ethics Committee of Faculty of Sociology and Social Work, University of Bucharest approval • Measures • demographics, treatment interruptions, VL&CD4, adherence, access to services.

  7. Sample characteristics

  8. Medical condition Last CD4 Last VL

  9. Treatment Alternative treatment Reason for last change Frequency of visits to regional center in 2010 for ART Number of schemes changed

  10. Unintended treatment interruptions in 2010 • No differences by age, occupation, education, income, gender or ethnicity • Average interruption: 38 days

  11. Strategies used when ART unavailable in 2010

  12. Consequences of interruptions

  13. Adherence 100% self-declared adherence: 59.1% - last month/36.1% ever

  14. Access to services

  15. Conclusions • There were no more interruptions reported in 2011-2012 • External factors (e.g. unintended treatment interruptions) + internal factors (e.g. treatment fatigue) negatively affect adherence in long-term treated persons • Virologic monitoring to be improved • Access to specialized medical services – limited • More analysis on the adherence + support for maintaining • Growing with HIV – treatment is part of everyday living • Romanian authorities must ensure continuoustreatment access for PLHIV to prevent deterioration of the health status.

  16. Research financed by: IrishAidIreland and UNAIDS Regional Office through UNICEF Romania and United Nations Development Programme. Thank you! Florin Lazăr florin.lazar@sas.unibuc.ro DoruBuzducea dbuzducea@yahoo.com

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